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Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes

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Abstract
We report on a comparative dosimetrical study between deep inspiration breath hold (DIBH) and shallow breathing (SB) in prone crawl position for photon and proton radiotherapy of whole breast (WB) and locoregional lymph node regions, including the internal mammary chain (LN_MI). We investigate the dosimetrical effects of DIBH in prone crawl position on organs-at-risk for both photon and proton plans. For each modality, we further estimate the effects of lung and heart doses on the mortality risks of different risk profiles of patients. Thirty-one patients with invasive carcinoma of the left breast and pathologically confirmed positive lymph node status were included in this study. DIBH significantly decreased dose to heart for photon and proton radiotherapy. DIBH also decreased lung doses for photons, while increased lung doses were observed using protons because the retracting heart is displaced by low-density lung tissue. For other organs-at-risk, DIBH resulted in significant dose reductions using photons while minor differences in dose deposition between DIBH and SB were observed using protons. In patients with high risks for cardiac and lung cancer mortality, average thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 3.12% (photon DIBH), 4.03% (photon SB), 1.80% (proton DIBH) and 1.66% (proton SB). The radiationrelated mortality risk could not outweigh the similar to 8% disease-specific survival benefit of WB + LN_MI radiotherapy in any of the assessed treatments.
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Multidisciplinary

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MLA
Speleers, Bruno, et al. “Effects of Deep Inspiration Breath Hold on Prone Photon or Proton Irradiation of Breast and Regional Lymph Nodes.” SCIENTIFIC REPORTS, vol. 11, no. 1, 2021, doi:10.1038/s41598-021-85401-4.
APA
Speleers, B., Schoepen, M., Belosi, F., Vakaet, V., De Neve, W., Deseyne, P., … De Gersem, W. (2021). Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes. SCIENTIFIC REPORTS, 11(1). https://doi.org/10.1038/s41598-021-85401-4
Chicago author-date
Speleers, Bruno, Max Schoepen, Francesca Belosi, Vincent Vakaet, Wilfried De Neve, Pieter Deseyne, Leen Paelinck, et al. 2021. “Effects of Deep Inspiration Breath Hold on Prone Photon or Proton Irradiation of Breast and Regional Lymph Nodes.” SCIENTIFIC REPORTS 11 (1). https://doi.org/10.1038/s41598-021-85401-4.
Chicago author-date (all authors)
Speleers, Bruno, Max Schoepen, Francesca Belosi, Vincent Vakaet, Wilfried De Neve, Pieter Deseyne, Leen Paelinck, Tom Vercauteren, Michael J. Parkes, Tony Lomax, Annick Van Greveling, Alessandra Bolsi, Damien C. Weber, Liv Veldeman, and Werner De Gersem. 2021. “Effects of Deep Inspiration Breath Hold on Prone Photon or Proton Irradiation of Breast and Regional Lymph Nodes.” SCIENTIFIC REPORTS 11 (1). doi:10.1038/s41598-021-85401-4.
Vancouver
1.
Speleers B, Schoepen M, Belosi F, Vakaet V, De Neve W, Deseyne P, et al. Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes. SCIENTIFIC REPORTS. 2021;11(1).
IEEE
[1]
B. Speleers et al., “Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes,” SCIENTIFIC REPORTS, vol. 11, no. 1, 2021.
@article{8700053,
  abstract     = {{We report on a comparative dosimetrical study between deep inspiration breath hold (DIBH) and shallow breathing (SB) in prone crawl position for photon and proton radiotherapy of whole breast (WB) and locoregional lymph node regions, including the internal mammary chain (LN_MI). We investigate the dosimetrical effects of DIBH in prone crawl position on organs-at-risk for both photon and proton plans. For each modality, we further estimate the effects of lung and heart doses on the mortality risks of different risk profiles of patients. Thirty-one patients with invasive carcinoma of the left breast and pathologically confirmed positive lymph node status were included in this study. DIBH significantly decreased dose to heart for photon and proton radiotherapy. DIBH also decreased lung doses for photons, while increased lung doses were observed using protons because the retracting heart is displaced by low-density lung tissue. For other organs-at-risk, DIBH resulted in significant dose reductions using photons while minor differences in dose deposition between DIBH and SB were observed using protons. In patients with high risks for cardiac and lung cancer mortality, average thirty-year mortality rates from radiotherapy-related cardiac injury and lung cancer were estimated at 3.12% (photon DIBH), 4.03% (photon SB), 1.80% (proton DIBH) and 1.66% (proton SB). The radiationrelated mortality risk could not outweigh the similar to 8% disease-specific survival benefit of WB + LN_MI radiotherapy in any of the assessed treatments.}},
  articleno    = {{6085}},
  author       = {{Speleers, Bruno and Schoepen, Max and Belosi, Francesca and Vakaet, Vincent and De Neve, Wilfried and Deseyne, Pieter and Paelinck, Leen and Vercauteren, Tom and Parkes, Michael J. and Lomax, Tony and Van Greveling, Annick and Bolsi, Alessandra and Weber, Damien C. and Veldeman, Liv and De Gersem, Werner}},
  issn         = {{2045-2322}},
  journal      = {{SCIENTIFIC REPORTS}},
  keywords     = {{Multidisciplinary}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{11}},
  title        = {{Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes}},
  url          = {{http://dx.doi.org/10.1038/s41598-021-85401-4}},
  volume       = {{11}},
  year         = {{2021}},
}

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